A CONVERGENT PARALLEL MIXED METHODS ANALYSIS OF SUCCESSFUL AGING IN CHINESE AMERICANS: DOES ACCULTURATION MATTER?

Abstract Chinese Americans comprise the largest Asian origin group aged 65 years and older (26%), yet little is known about how aging, particularly in the context of acculturation, is experienced within this group. Further, although immigration scholarship underscores a robust, positive relationship between successful aging and acculturation, how major lifecourse events shape perceptions of aging well in Chinese Americans is not well-understood. Using an intersectional lifecourse perspective, this convergent parallel mixed methods study presents integrated findings from a cross-sectional survey (N=98; 58.2% female; mean age=64.4 years) and qualitative interviews (N=32; 53% female; mean age=59.4 years) with community-dwelling Chinese Americans 50+, about 80% of whom were foreign-born. Survey measures included the Short Acculturation Scale, the Successful Aging Scale, self-reported health, and demographic variables. Quantitative data were analyzed using multiple regression analysis. No significant association was found between acculturation and successful aging, even after controlling for length of stay and sociodemographic variables. Thematic analysis of qualitative data revealed feelings of ambivalence and alienation. Several participants shared that despite having lived in the US for decades, they felt like they “no longer belonged”, feared for their safety, and felt a “sense of betrayal” after the recent increase in Anti-Asian hate crimes. Many were planning to return to their home country, where they believed it would be easier to age successfully. These findings suggest that important turning points in the lifecourse trajectory, such as experiences of racism, can negatively influence perceptions of aging in Chinese Americans, regardless of degree of acculturation and length of stay.

societies, where caring for older family members is culturally expected and appraised yet is associated with stress and burden.Numerous studies have shown that fulfilment of filial piety contributes to better psychological outcomes for caregivers while mismatched filial expectations contribute to poorer psychological outcomes.However, few studies acknowledge how filial care varies according to individual resources and socio-cultural contexts.We seek to understand how family caregivers negotiate their self-determination through filial care, which contributes to positive and negative caregiving experiences.We conducted in-depth interviews with 34 caregivers of older persons with functional limitations in Singapore, purposefully selected based on varying positive and negative caregiving experiences.For caregivers with predominantly negative caregiving experiences, filial care was seen as an act of sacrifice and expectation of duty, with low autonomy to exercise self-determination.In comparison, caregivers with predominantly positive caregiving experiences described filial care as an act of sincere love cultivated through close relationships with their care-recipient, and aligned to their self-determination.Strong family support was also evident in the latter.Treating filial piety as a 'natural desire to care for parents' obscures efforts required to amplify positive caregiving experiences while normalisation of self-sacrifice and suffering hinders caregivers from expressing burden and accessing support.A nuanced understanding of how caregivers negotiate filial care can inform policy interventions to empower caregivers and carerecipients and enhance intergenerational relationships.Loneliness can be contagious because lonely people tend to share their loneliness with others.According to this perspective, loneliness in older persons with cognitive impairment (PCI) may beget loneliness in their family caregivers.However, not all caregivers of lonely PCI experience loneliness.This may be because caregivers have buffering resources that mitigate the contagion of loneliness.Nevertheless, empirical evidence on whether and how PCI and caregiver loneliness are related is lacking.Therefore, we examined the association between PCI loneliness and caregiver loneliness, and the moderation role of caregiver mastery on this association.We used dyadic data from 135 PCI and their family caregivers in Singapore.Descriptive statistics and bivariate correlation showed that PCI reported higher levels of loneliness than their caregivers, and PCI and caregiver loneliness were weakly related.Multivariable regression showed that PCI loneliness was not associated with caregiver loneliness, taking other covariates into account.Nevertheless, we found that the interaction between PCI loneliness and caregiver sense of mastery was significant, such that PCI loneliness was significantly associated with caregiver loneliness when caregivers had low mastery.In conclusion, lonely PCI may share their loneliness with their caregivers, and this may lead to caregiver loneliness if caregivers have low mastery.Tailored interventions should be designed to reduce loneliness among PCI and their caregivers and improve caregiver mastery as a protective factor against the spread of loneliness between PCI and caregivers.
Abstract citation ID: igad104.1220Jane Lowers 1 , Ivree Datcher 2 , Michelle Delk 3 ,  Dio Kavalieratos 2 , Molly Perkins 2 , and Kenneth Hepburn 2 , 1. Emory School of Medicine,Atlanta,Georgia,United States,2. Emory University,Atlanta,Georgia,United States,3. Emory Rol,Atlanta,Georgia,United States One in three people with Alzheimer's or other dementias lives alone, without a spouse/partner or nearby children (i.e., is aging solo).Friends, neighbors, and extended family often assist with tasks that preserve independence, but most dementia caregiving literature, and theory, to date focuses on spousal or parent/child dyads for whom reciprocity, indebtedness and self-interest are common motivators.This study seeks to address this knowledge gap.Design: Semi-structured interviews with caregivers of adults with cognitive impairment or dementia who were not the caregivers' spouses or parents.Hybrid inductive/deductive thematic analysis incorporating social exchange and stress-coping theories.

IT'S OVERWHELMING FOR EVERYBODY: EXPERIENCES OF DEMENTIA CAREGIVERS WHO AREN'T CLOSE FAMILY
Results: We interviewed 11 caregivers (100% female; age 54-85, mean 71; 91% white, 9% black; 27% friend; 27% church congregant; 27% sibling or in-law; 18% neighbor).Caregivers described altruism, empathy, and, in cases of extended family, duty as motivators to provide care for acquaintances with dementia.Caregivers who themselves lacked close family identified with their care recipient's vulnerability and the possibility of needing similar care someday.Non-family caregivers described feeling unprepared and unqualified to make legal, financial, and guardianship decisions and looked to care recipients' distant family, health care providers, and religious leaders to guide decisions that require balancing care recipients' safety and autonomy, such as moving to a nursing home.
Conclusion: Dementia caregiving outside spouse or parent/child dyads can produce practical and emotional challenges for caregivers who are not immediate family.These caregivers may benefit from guidance about practical and ethical decisions in the absence of immediate family decision makers.
aging, particularly in the context of acculturation, is experienced within this group.Further, although immigration scholarship underscores a robust, positive relationship between successful aging and acculturation, how major lifecourse events shape perceptions of aging well in Chinese Americans is not well-understood.Using an intersectional lifecourse perspective, this convergent parallel mixed methods study presents integrated findings from a cross-sectional survey (N=98; 58.2% female; mean age=64.4years) and qualitative interviews (N=32; 53% female; mean age=59.4years) with community-dwelling Chinese Americans 50+, about 80% of whom were foreign-born.Survey measures included the Short Acculturation Scale, the Successful Aging Scale, selfreported health, and demographic variables.Quantitative data were analyzed using multiple regression analysis.No significant association was found between acculturation and successful aging, even after controlling for length of stay and sociodemographic variables.Thematic analysis of qualitative data revealed feelings of ambivalence and alienation.Several participants shared that despite having lived in the US for decades, they felt like they "no longer belonged", feared for their safety, and felt a "sense of betrayal" after the recent increase in Anti-Asian hate crimes.Many were planning to return to their home country, where they believed it would be easier to age successfully.These findings suggest that important turning points in the lifecourse trajectory, such as experiences of racism, can negatively influence perceptions of aging in Chinese Americans, regardless of degree of acculturation and length of stay.

ALZHEIMER'S DISEASE AND RELATED DEMENTIAS DIAGNOSES IN THE US BY RACE, ETHNICITY, AND NATIVITY
Tiffany Kindratt 1 , Laura Zahodne 2 , Kristine Ajrouch 3 , and Florence Dallo 4 , 1. University of Texas at Arlington, Arlington, Texas, United States, 2. University of Michigan,Ann Arbor,Michigan,United States,3. Eastern Michigan University,Ypsilanti,Michigan,United States,4. Oakland University,Rochester,Michigan,United States Timely clinical diagnosis of ADRD is important for intervention, resource allocation, and mitigating safety concerns.While studies have examined ADRD diagnoses disparities by race/ethnicity, few include its intersection with nativity.Our aims were to: 1) estimate the odds of diagnosed ADRD among US-and foreign-born racial/ethnic groups compared to US-born White older adults and 2) compare US-and foreign-born older adults within each racial/ethnic group.We linked 2000-2017 National Health Interview Survey (NHIS) and 2001-2018 Medical Expenditure Panel Survey (MEPS) data (65+ years; n=38,033).Race/ethnicity and nativity were measured using NHIS data.Diagnosed ADRD was determined using ICD-9 (290/294/331/797) or ICD-10 (F01/F03/ G30/G31) billing codes created from self-reported ADRD diagnoses during MEPS household interviews.Covariates were measured using MEPS data.US-born Black (OR=1.74;95%CI=1.48-2.05),Hispanic (OR=1.62;95%CI=1.14-2.29)and foreign-born Hispanic (OR=1.63;95%CI=1.24-2.15)older adults had higher odds of diagnosed ADRD compared to US-born White older adults after adjusting for age and sex.Results were no longer significant among either Hispanic group after adjusting for education, health insurance, and access to care.However, after adjusting for education, health insurance, access to care, and chronic conditions, US-born Black older adults, but not foreign-born Black older adults, had 1.54 times greater odds (95%CI=1.27-1.87) of diagnosed ADRD compared to US-born White older adults.There were no statistically significant differences in ADRD diagnosis by nativity within each racial/ethnic minoritized group.Findings highlight the need for including nativity in studies comparing racial/ethnic groups to Whites to fully capture the burden of ADRD among US-born Black older adults.

ASSOCIATIONS BETWEEN SEDENTARY AND PHYSICAL INACTIVITY ON QUALITY OF LIFE IN THAI MIDDLE AGE AND OLDER OFFICE WORKERS
Katika Akksilp 1 , Yot Teerawattananon 2 , and Cynthia Chen 1 , 1. National University of Singapore, Singapore, Singapore,2. Health Intervention and Technology Assessment Program,Muang Nonthaburi,Nonthaburi,Thailand Sedentary behaviour and physical inactivity negatively affect health-related quality of life in all age groups.Moreover, the ageing population needs even more sophisticated health promotion programmes to tackle the increasing prevalence of non-communicable diseases.This study aims to estimate the effects of sedentary behaviour and physical inactivity on health-related quality of life among middle-age and older office workers in Thailand.The analyses used secondary data from the Physical Activity at Work cluster-randomised trial.Objective physical activity data were collected using the ActiGraph™ accelerometer.Health-related quality of life was collected using EuroQol's EQ-5D-5L.Sedentary was defined as spending more than nine hours per day in sedentary behaviours.Physically inactive was defined as spending less than 150 minutes of moderate-intensity equivalent activity per week.Tobit regression was used to compare utility indices.Being physically active alone was associated with a higher EQ-5D value (0.0746; 95%CI -0.0142 to 0.163) compared to the inactive.Also, non-sedentary participants had higher EQ-5D value (0.0548; 95%CI -0.0121 to 0.122) compared to sedentary, although not statistical significance.In addition, participants who were both physically active and not sedentary had a significant difference in the EQ-5D value of 0.0700 (95%CI 0.00187 -0.138) compared to inactive and sendentary participants.This is the first study in Thailand to explore the association between sedentary behaviour, physical inactivity on health-related quality of life in middle-age and older population.It highlights the importance of incorporating health-related quality of life assessment for Thai physical activity promotion programmes, building a foundation for economic evaluation studies.